VTE Prophylaxis Options for Surgery

Surgery Type	Recommended Prophylaxis Options*
Intracranial Neurosurgery Appendix A, Table 5.17	Any of the following: Intermittent pneumatic compression devices (IPC) with or without graduated compression stockings (GCS). Low-dose unfractionated heparin (LDUH). Low molecular weight heparin (LMWH).† LDUH or LMWH† combined with IPC or GCS. † Current guidelines recommend postoperative low molecular weight heparin for Intracranial Neurosurgery.
General Surgery Appendix A, Table 5.19	Any of the following: Low-dose unfractionated heparin (LDUH). Low molecular weight heparin (LMWH). Factor Xa Inhibitor (Fondaparinux) LDUH or LMWH or Factor Xa Inhibitor (fondaparinux) combined with IPC or GCS.
General Surgery with contraindications to pharmacological prophylaxis Appendix A, Table 5.19	Any of the following: Graduated Compression stockings (GCS). Intermittent pneumatic compression devices (IPC).
Gynecologic Surgery Appendix A, Table 5.20	Any of the following: Low-dose unfractionated heparin (LDUH). Low molecular weight heparin (LMWH). Factor Xa Inhibitor (fondaparinux). Intermittent pneumatic compression devices (IPC). LDUH or LMWH or Factor Xa Inhibitor (fondaparinux) combined with IPC or GCS.
Urologic Surgery Appendix A, Table 5.21	Any of the following: Low-dose unfractionated heparin (LDUH). Low molecular weight heparin (LMWH). Factor Xa Inhibitor (fondaparinux). Intermittent pneumatic compression devices (IPC). Graduated compression stockings (GCS). LDUH or LMWH or Factor Xa Inhibitor (fondaparinux) combined with IPC or GCS.
Elective Total Hip Replacement Appendix A, Table 5.22	Any of the following started within 24 hours of surgery: Low molecular weight heparin (LMWH). Factor Xa Inhibitor (Fondaparinux) Warfarin.
Elective Total Knee Replacement Appendix A, Table 5.23	Any of the following: Low molecular weight heparin (LMWH). Factor Xa Inhibitor (Fondaparinux). Warfarin. Intermittent pneumatic compression devices (IPC). Venous foot pump (VFP)
Hip Fracture Surgery Appendix A, Table 5.24	Any of the following: Low-dose unfractionated heparin (LDUH). Low molecular weight heparin (LMWH). Factor Xa Inhibitor (Fondaparinux) Warfarin.
Elective Total Hip Replacement with contraindications to pharmacological prophylaxis Appendix A, Table 5.22	Any of the following: Intermittent pneumatic compression devices (IPC). Venous foot pump (VFP).
Hip Fracture Surgery with contraindications to pharmacological prophylaxis Appendix A, Table 5.24	Any of the following: Graduated Compression Stockings (GCS). Intermittent pneumatic compression devices (IPC). Venous foot pump (VFP).

* Patients who receive neuraxial anesthesia or have a documented contraindication to pharmacological prophylaxis may pass the performance measure if either appropriate pharmacological or mechanical prophylaxis is ordered.

To view the medication tables referenced in this document, go to: Appendix A: ICD-9-CM Code Tables.

VTEProphylaxis Optionsfor Surgery

Specifications Manual for Joint Commission National Quality Core Measures (2010A1)
Discharges 04-01-10 (2Q10) through 09-30-10 (3Q10)